DLOSCE™ Historical Timeline | Joint Commission on National Dental Examinations

DLOSCE™ history and purpose

Details on the development, content and purpose of the Dental Licensure Objective Structured Clinical Examination.

About the DLOSCE

The Dental Licensure Objective Structured Clinical Examination is a high-stakes exam consisting of multiple questions requiring candidates to use their clinical skills to successfully complete one or more dental problem-solving tasks. The exam is designed to provide information to U.S. dental boards who seek to determine if candidates for dental licensure have the necessary level of clinical skills to safely practice entry-level dentistry. The DLOSCE is a valid and reliable examination that has been professionally developed by the Joint Commission on National Dental Examinations (JCNDE).

The DLOSCE is available to all state dental boards nationwide. Examination content is the same for all regions of the country, regardless of the curriculum implemented at different dental schools.

View DLOSCE Quick Facts Sheet (PDF)

Questions and answers about the DLOSCE

When was the DLOSCE created? Which milestones were involved?

This timeline gives an overview of the DLOSCE’s development.


ADA’s Council on Dental Education and Licensure (CDEL) charged the Department of Testing Services (DTS) with developing a business plan for development and implementation of a Dental Licensure Objective Structured Clinical examination. CDEL reviewed the plan at their December 2016 meeting and recommended the ADA’s Board of Trustees provide development funding to create the examination.


A National Licensure Task Force jointly sponsored by ADA and ADEA unanimously endorsed the development of the DLOSCE at its January 2017 meeting.

The ADA Board of Trustees spent considerable time at its February 2017 Board Meeting discussing the DLOSCE business plan written by the Department of Testing Services. The Board of Trustees authorized the formation of a DLOSCE Steering Committee charged with developing and validating the DLOSCE. ADA President Gary L. Roberts appointed members of the Steering Committee based on criteria established by the Board of Trustees. The Board voted to fund the initial costs for exam development.

Two articles were published announcing the development of the DLOSCE.

The DLOSCE Steering Committee held its inaugural meeting in July 2017 at ADA headquarters in Chicago. The Committee also met via conference call in December 2017.


In March 2018, a Test Specifications Review Panel composed of 11 industry experts and three steering committee members was formed to create a recommendation for DLOSCE test specifications. These specifications included the examination’s major content areas and the corresponding percentage of questions for each area. The Steering Committee approved these specifications at a meeting later that same month.

In addition to the March 2018 meeting, the Steering Committee met via conference call in May 2018. During this meeting, the Steering Committee identified 28 test constructors, including general dentists and general educators with broad expertise. The Steering Committee also authorized the formation of a working committee to assist in recommending the Test Committee Team structure and developing DLOSCE question templates.

The Steering Committee met via conference call in winter 2018.

ADA’s Department of Testing Services, along with members of the Steering Committee, gave several presentations on the DLOSCE:

  • ADEA Annual Session
  • Southern Deans
  • Oregon Board of Dentistry
  • University of Washington
  • Oregon Health Sciences University
  • Washington State Dental Association
  • American Association of Dental Boards
  • American Association of Endodontists
  • ADA Council on Dental Education and Licensure
  • Washington Dental Quality Assurance Commission (meeting pending)


A presentation offering updates to the DLOSCE was given at the 2019 ADEA Annual Session.


The DLOSCE launched in May.

The DLOSCE program was officially assigned to the JCNDE, which now serves as the governing body for this exam.

What is an Objective Structured Clinical Examination (OSCE)? 

OSCEs are widely used in the health sciences, including optometry, medicine, physical therapy, radiography, rehabilitation medicine, nursing, pharmacy, podiatry, and veterinary medicine. Since their inception in the 1970s, OSCEs are now part of the U.S. Medical Licensing Examination for all medical graduates.

The OSCE examination format often includes stimulus materials such as radiographs, photographs, models, and prescription writing. Standardized patients (actors) have been used in medical OSCEs. The National Dental Examining Board (NDEB) of Canada uses an OSCE for dental licensure throughout the country. The exam is presented as a written, multiple-choice examination that presents stimulus materials in multiple stations. Advances in simulated patient and haptic technologies suggest that simulations may be incorporated in a dental OSCE sooner rather than later.

OSCEs were developed to help accurately assess the complex notion of clinical competence in the medical field. More specifically, Harden, Stevenson, Wilson Downie, and Wilson (1975) indicated that they introduced the OSCE format to avoid many of the weaknesses and disadvantages of traditional clinical examinations.

Which states currently accept the DLOSCE?

The states below have adopted regulations to accept the DLOSCE. In some states, passage of the DLOSCE only partially fulfills the clinical examination requirements for licensure. Please refer to each state board’s website for specific details, clarifications and updated policies.







Why did the Joint Commission on National Dental Examinations develop the DLOSCE?

The JCNDE has a long and successful track record of delivering high quality, high-stakes examinations for licensure purposes – exams that help protect the public.

As the governing body that oversees both the NBDE and DLOSCE programs, the JCNDE is positioned to provide a comprehensive evaluation of the skills necessary to safely practice dentistry.

The JCNDE is a Commission with mechanisms in place to reduce conflicts of interest and help ensure that no single community of interest has an undue influence on governance decisions related to the DLOSCE.

The JCNDE possesses the in-house expertise to develop an OSCE through the Department of Testing Services (DTS), which is staffed by testing professionals with advanced degrees in psychological measurement and related fields.

Lastly and most importantly, the JCNDE feels that a DLOSCE protects the public health more effectively than existing clinical licensure solutions.

How is DLOSCE content determined?

Consistent with the Standards for Educational and Psychological Testing established by the American Educational Research Association, the American Psychological Association and the National Council on Measurement in Education (2014), the content of the DLOSCE is based on a practice analysis involving entry-level general dentists. The DLOSCE practice analysis involves collecting information on the tasks performed by these dentists with regard to their frequency and criticality for patient care. This information is used to identify the clinical areas to be tested and the numbers of items and OSCE stations devoted to these areas.

Where can I find information on the validity of the examination and examination scores?

The JCNDE has published a validity summary for dental boards and other interested parties who may be considering DLOSCE as a means of evaluating test candidates for licensure. Boards and other interested parties may also review a technical report that explores the validity of examination scores.

View the validity summary (PDF)

View the technical report (PDF)

Where can I go for more information?
If you have additional questions, please contact the Joint Commission on National Dental Examinations at 800.232.1694 or nbexams@ada.org.